TY - JOUR
T1 - Axis I diagnoses and transition to psychosis in clinical high-risk patients EPOS project: Prospective follow-up of 245 clinical high-risk outpatients in four countries
AU - Salokangas, Raimo K. R.
AU - Ruhrmann, Stephan
AU - von Reventlow, Heinrich Graf
AU - Heinimaa, Markus
AU - Svirskis, Tanja
AU - From, Tiina
AU - Luutonen, Sinikka
AU - Juckel, Georg
AU - Linszen, Don
AU - Dingemans, Peter
AU - Birchwood, Max
AU - Patterson, Paul
AU - Schultze-Lutter, Frauke
AU - Klosterkötter, Joachim
AU - AUTHOR GROUP
AU - Picke, Heinz
AU - Neumann, Meike
AU - Brockhaus-Dumke, Anke
AU - Pukrop, Ralf
AU - Huttunen, Jukka
AU - Laine, Tiina
AU - Ilonen, Tuula
AU - Ristkari, Terja
AU - Hietala, Jarmo
AU - Becker, Hiske
AU - Nieman, Dorien
AU - Skeate, Amanda
AU - Gudlowski, Yehonala
AU - Ozgürdal, Seza
AU - Witthaus, Henning
AU - French, Paul
AU - Stevens, Helen
PY - 2012
Y1 - 2012
N2 - Background: In selected samples, a considerable number of patients at clinical high risk of psychosis (CHR) are found to meet criteria for co-morbid clinical psychiatric disorders. It is not known how clinical diagnoses correspond to or even predict transitions to psychosis (TTP). Our aim was to examine distributions of life-time and current Axis I diagnoses, and their association with TTP in CHR patients. Methods: In the EPOS (European Prediction of Psychosis Study) project, six European outpatient centres in four countries examined 245 young help-seeking patients, who fulfilled the inclusion criteria for clinical risk of psychosis according to the Structured Interview for Prodromal Syndromes (SIPS 3.0) or the Bonn Scale for the Assessment of Basic Symptoms - Prediction List basic symptoms (BASBS-P). Patients who had experienced a psychotic episode lasting more than one week were excluded. Baseline and life-time diagnoses were assessed by the Structured Clinical Interview for DSM-IV (SCID-I). TTP was defined by continuation of BLIPS for more than seven days and predicted in Cox-regression analysis. Results: Altogether, 71% of the CHR patients had one or more life-time and 62% one or more current SCID-I diagnosis; about a half in each category received a diagnosis of life-time depressive and anxiety disorder. Currently, 34% suffered from depressive and 39% from anxiety disorder. Four percent received a current SCID diagnosis of bipolar, and 6.5% of somatoform disorder. During follow-up, 37 (15.1%) patients had developed full-blown psychosis. In bivariate analyses, current non-psychotic bipolar disorder associated significantly with TTP. In multivariate analyses, current bipolar disorder, somatoform and unipolar depressive disorders associated positively, and anxiety disorders negatively, with TTP. Conclusions: Both life-time and current mood and anxiety disorders are highly prevalent among clinical help-seeking CHR patients and need to be carefully evaluated. Among CHR patients, occurrence of bipolar, somato-form and depressive disorders seems to predict TTP, while occurrence of anxiety disorder may predict non-transition to psychosis. (C) 2012 Elsevier B.V. All rights reserved
AB - Background: In selected samples, a considerable number of patients at clinical high risk of psychosis (CHR) are found to meet criteria for co-morbid clinical psychiatric disorders. It is not known how clinical diagnoses correspond to or even predict transitions to psychosis (TTP). Our aim was to examine distributions of life-time and current Axis I diagnoses, and their association with TTP in CHR patients. Methods: In the EPOS (European Prediction of Psychosis Study) project, six European outpatient centres in four countries examined 245 young help-seeking patients, who fulfilled the inclusion criteria for clinical risk of psychosis according to the Structured Interview for Prodromal Syndromes (SIPS 3.0) or the Bonn Scale for the Assessment of Basic Symptoms - Prediction List basic symptoms (BASBS-P). Patients who had experienced a psychotic episode lasting more than one week were excluded. Baseline and life-time diagnoses were assessed by the Structured Clinical Interview for DSM-IV (SCID-I). TTP was defined by continuation of BLIPS for more than seven days and predicted in Cox-regression analysis. Results: Altogether, 71% of the CHR patients had one or more life-time and 62% one or more current SCID-I diagnosis; about a half in each category received a diagnosis of life-time depressive and anxiety disorder. Currently, 34% suffered from depressive and 39% from anxiety disorder. Four percent received a current SCID diagnosis of bipolar, and 6.5% of somatoform disorder. During follow-up, 37 (15.1%) patients had developed full-blown psychosis. In bivariate analyses, current non-psychotic bipolar disorder associated significantly with TTP. In multivariate analyses, current bipolar disorder, somatoform and unipolar depressive disorders associated positively, and anxiety disorders negatively, with TTP. Conclusions: Both life-time and current mood and anxiety disorders are highly prevalent among clinical help-seeking CHR patients and need to be carefully evaluated. Among CHR patients, occurrence of bipolar, somato-form and depressive disorders seems to predict TTP, while occurrence of anxiety disorder may predict non-transition to psychosis. (C) 2012 Elsevier B.V. All rights reserved
U2 - 10.1016/j.schres.2012.03.008
DO - 10.1016/j.schres.2012.03.008
M3 - Article
C2 - 22464922
SN - 0920-9964
VL - 138
SP - 192
EP - 197
JO - Schizophrenia research
JF - Schizophrenia research
IS - 2-3
ER -